The invention is directed to compounds that are useful in treating inflammation and that contain N-containing heterocycles such as piperazine or piperidine moieties coupled to phenyl and other aryl groups. More particularly, the invention concerns novel compounds of this type as well as methods to treat heart and kidney conditions using these and other compounds.
A large number of chronic and acute conditions have been recognized to be associated with perturbation of the inflammatory response. A large number of cytokines participate in this response, including IL-1, IL-6, IL-8 and TNF. It appears that the activity of these cytokines in the regulation of inflammation rely at least in part on the activation of an enzyme on the cell signaling pathway, a member of the MAP kinase family generally known as p38 and alternatively known as CSBP and RK. This kinase is activated by dual phosphorylation after stimulation by physiochemical stress, treatment with lipopolysaccharides or with proinflammatory cytokines such as IL-1 and TNF. Therefore, inhibitors of the kinase activity of p38 are useful antiinflammatory agents.
PCT applications WO98/06715, WO98/07425, WO98/28292 and WO 96/40143, all of which are incorporated herein by reference, describe the relationship of p38 kinase inhibitors with various disease states. As mentioned in these applications, inhibitors of p38 kinase are useful in treating a variety of diseases associated with chronic inflammation. These applications list rheumatoid arthritis, rheumatoid spondylitis, osteoarthritis, gouty arthritis and other arthritic conditions, sepsis, septic shock, endotoxic shock, Gram-negative sepsis, toxic shock syndrome, asthma, adult respiratory distress syndrome, stroke, reperfusion injury, CNS injuries such as neural trauma and ischemia, psoriasis, restenosis, cerebral malaria, chronic pulmonary inflammatory disease, silicosis, pulmonary sarcosis, bone resorption diseases such as osteoporosis, graft-versus-host reaction, Crohn""s Disease, ulcerative colitis including inflammatory bowel disease (IBD) and pyresis.
The above-referenced PCT applications disclose compounds which are p38 kinase inhibitors said to be useful in treating these disease states. These compounds are either imidazoles or are indoles substituted at the 3- or 4-position with a piperazine or piperidine ring linked through a carboxamide linkage. Additional compounds which are conjugates of piperazines with indoles are described as insecticides in WO97/26252, also incorporated herein by reference.
U.S. Pat. No. 5,719,135 describes tyrosine kinase inhibitors containing piperidine or piperazine rings linked through a methylene at position 1 of piperidine to various aromatic systems which must further contain a xcex3 lactam fused to a pyridine ring. Similar compounds are described in U.S. Pat. No. 5,663,346 and in WO096/22976. Other cyclic tyrosine kinase inhibitors are described in PCT application WO095/06032. In addition, WO094/20062 describes balanoids as protein kinase C inhibitors. The balanoid compounds contain multiple aromatic systems which include at least a ring containing at least seven members. Some of the compounds useful in the method of the present invention are known compounds.
The invention is directed to methods of treating inflammation generally, including specific conditions such as those described in the Background section above. The compounds of the invention have been found to inhibit p38 kinase and are thus useful in treating diseases mediated by this enzyme. These compounds also inhibit p38xcex1 preferentially as compared to their inhibition of p38xcex2 as is further discussed below.
The compounds useful in the invention are of the formula 
and the pharmaceutically acceptable salts thereof, or a pharmaceutical composition thereof,
wherein
Z is N or CR1, R1 is a noninterfering substituent,
each of X1 and X2 is a linker,
Ar1 and Ar2 are identical or different, and represent optionally substituted C1-C20 hydrocarbyl residues wherein at least one of Ar1 and Ar2 is an optionally substituted aryl group, with the proviso that when X2 is CH2 or an isostere thereof, X1 is CO or an isostere thereof, and Ar2 is optionally substituted phenyl, Ar1 is other than an optionally substituted indolyl, benzimidazolyl or benzotriazolyl substituent, and wherein said optionally substituted phenyl is not an optionally substituted indolyl, benzimidazolyl, or benzotriazolyl,
Y is a noninterfering substituent, wherein n is an integer from 0-4, and
wherein m is an integer from 0-4 and 1 is an integer from 0-3.
Preferably, the compounds useful in the invention are of the formula 
and the pharmaceutically acceptable salts thereof,
wherein Ar1 is optionally substituted furanyl, thiophenyl, phenyl system having 0, 1, or 2 heterocyclic N atoms or naphthyl system having 0, 1, 2 or 3 heterocyclic N atoms;
X1 is CO or an isostere thereof;
Y is optionally substituted alkyl (1-6C), optionally substituted aryl (6-10C), or optionally substituted arylalkyl (7-11C);
n is 0 or 1;
Z is CH or N;
X2 is CH2 or an isostere thereof; and
Ph is optionally substituted phenyl.
The optional substituents on the aryl moieties (including phenyl) include halo, nitro, optionally substituted alkyl (1-6C) or alkenyl (1-6C), CN, guanidino or CF3, as well as RCO, COOR, CONR2, SO2NR2, xe2x80x94OOCR, xe2x80x94NROCR, xe2x80x94NROCOR, NR2, OR or SR, wherein R is H or alkyl (1-6C), as well as substitution by phenyl, itself optionally substituted by the foregoing substituents. Any two substituents may form a 5-7 membered carbocyclic or heterocyclic ring subject to the proviso.
Thus, in one aspect, the invention is directed to compounds of the formulas set forth above and to pharmaceutical compositions containing them. In other aspects, the invention is directed to methods of treatment using compounds of the formula set forth above. The invention is also directed to specific classes of compounds within the genus of formula (1). In other aspects, the invention is directed to methods to produce the classes of compounds useful in the invention.
The compounds of formula (1) set forth above are defined by the nature of the substituents on the heterocycloalkyl ring in the center of the formula. Piperazine or piperidine rings are preferred and piperidine rings are more preferred. The central piperazine or piperidine ring can be expanded or contracted using xe2x80x94CH2 groups so that it includes from 4 members up to 11 members. The substitution on this ring is on the N or Z positions only. Although not bound by this theory, the function of the central heterocycloalkyl group is apparently to space the Ar2 group, which is generally hydrophobic, from the Ar1 group, which is preferably but not necessarily hydrophilic.
The central heterocycloalkyl ring can include from 1-2 N. If the ring contains only 1 N then Z is a xe2x80x94CR1 wherein R1 is a noninterfering substituent. Preferably, R1 is alkyl, alkoxy, aryl, arylalkyl, aryloxy, heteroaryl, halogen, acyl, carboxy, or hydroxy. More preferably, R1 is hydroxy, alkyl, or alkoxy.
The linker that couples the central heterocycloalkyl ring and the Ar1 and Ar2 groups on either end of the molecule are preferably saturated or unsaturated alkylene optionally containing 1-4 carbonyl, 1-4 SO2, and/or 1-3 heteroatoms, including a linker which is CO, SO2, SO or contains a heteroatom, and optionally substituted with a substituent selected from the group consisting of halo, alkyl, alkoxy, cycloalkyl, aryl, aryloxy, arylalkyl, haloalkyl, polyhaloalkyl, haloalkoxy, polyhaloalkoxy, cycloheteroalkyl, cycloheteroalkylalkyl, heteroaryl, heteroarylalkyl, heteroaryloxy, arylthio, arylsulfinyl, arylsulfonyl, heteroarylthio, heteroarylsulfinyl, heteroarylsulfonyl, alkylaminocarbonyl, arylaminocarbonyl, heteroarylaminocarbonyl, alkoxycarbonyl, aryloxycarbonyl, heteroaryloxycarbonyl, acyl, aminocarbonyl, arylcarbonyl, heteroarylcarbonyl, cyano, carboxy, hydroxy, tetrazolyl, imidazole, oxazole, triazole, and xe2x80x94SOR wherein R is hydroxy, alkyl, aryl, alkoxy, aryloxy, cycloalkyl, heteroaryl, heteroarylalkyl, heteroaryloxy, heteroarylalkoxy or cycloheteroalkylalkoxy.
Preferably the linker is a methylene group, a carbonyl group, a methylene group coupled to a carbonyl group, a methylene group having a methyl substituent or a methylene group containing an optionally substituted phenyl group. The alkylene group is C1-C8, and preferably C1-C4, and more preferably C1. Preferably, haloalkyl or polyhaloalkyl groups are CF3 or CF3CH2 and haloalkoxy or polyhaloalkoxy groups are CF3O or CF3CH2O.
Ar1 or Ar2 is an aryl group which is the residue of an aromatic hydrocarbon containing one or more rings optionally including one or more heteroatoms, selected from the group of O, N and S. Preferably the aryl group has 6-12 carbon atoms and up to 3 heteroatoms, and more preferably the aryl group has 6-8 carbon atoms and 1 or 2 heteroatoms. More preferably, the aryl group is a saturated or unsaturated 5-7 membered heterocycle and even more preferably a saturated or unsaturated 5-6 membered heterocycle. Most preferably, the aryl group is phenyl or residues of an optionally benzo-fused heterocycle containing up to 3 heteroatoms selected from S, N and O. The most preferable aryl groups are indolyl, isoquinolyl, quinolyl, benzimidazolyl, benzotriazolyl, benzothiazolyl, benzofuranyl, pyridyl, thienyl, furyl, pyrrolyl, thiazolyl, oxazolyl, imidazolyl, morpholinyl or piperidyl. When the linker is not CO or an isostere thereof, Ar1 or Ar2 is most preferably indolyl, benzimidazolyl or benzotriazolyl.
Ar1 and Ar2 and/or other aryl substituents are optionally substituted with substituents including one or more of halo, alkyl, alkoxy, cycloalkyl, aryl, aryloxy, arylalkyl, haloalkyl, polyhaloalkyl, haloalkoxy, polyhaloalkoxy, cycloheteroalkyl, cycloheteroalkylalkyl, heteroaryl, heteroarylalkyl, heteroaryloxy, arylthio, arylsulfinyl, arylsulfonyl, heteroarylthio, heteroarylsulfinyl, heteroarylsulfonyl, alkylaminocarbonyl, arylaminocarbonyl, heteroarylaminocarbonyl, alkoxycarbonyl, aryloxycarbonyl, heteroaryloxycarbonyl, acyl, aminocarbonyl, arylcarbonyl, heteroarylcarbonyl, cyano, carboxy, hydroxy, tetrazolyl, imidazole, oxazole, triazole, and xe2x80x94SOR wherein R is hydroxy, alkyl, aryl, alkoxy, aryloxy, cycloalkyl, heteroaryl, heteroarylalkyl, heteroaryloxy, heteroarylalkoxy or cycloheteroalkylalkoxy. Preferably the substituents include halo, alkoxy, alkoxyaryl, aminoalkyl, aminoaryl, and substituted aryl. Most preferably Ar1 and Ar2 include at least one halo, alkoxy, or N-containing substituent.
Y is selected from the group consisting of H, optionally substituted alkyl, alkoxy, cycloalkyl, cycloheteroalkyl, aryl, cycloheteroalkyl, heteroaryl, halogen, alkylaminocarbonyl, arlyaminocarbonyl, heteroarylaminocarbonyl, acyl, carboxy, hydroxy, aminocarbonyl, arylcarbonyl, heteroarylcarbonyl, cyano, amino, and alkylamino. Preferred groups are hydroxy, alkyl and carbonyl.
The compounds of formula (2) set forth above are defined by the nature of the substituents on the piperazine or piperidine ring. Piperidine rings are preferred.
In formula (2), Ar1 is optionally substituted furanyl, thiophenyl, optionally substituted phenyl systems having 0, 1, or 2 heterocyclic N atoms or naphthyl systems having 0, 1, 2 or 3 heterocyclic N atoms. The nature of the substituents and the preferred substituents are discussed below.
X1 is CO or an isostere thereof. Thus, in addition to CO, X1 may be CH2, SO, SO2, or CHOH. CO is preferred.
Z is CH or N.
X2 is CH2 or an isostere thereof
The aryl moieties represented by Ar1 and Ph in formula (2) may optionally be substituted by substituents including straight or branched chain alkyl (1-6C), straight or branched chain alkenyl (2-6C), halo, RCO, COOR, CONR2, SO2NR2, xe2x80x94OOCR, xe2x80x94NROCR, xe2x80x94NROCOR, OR, SR, NR2, NO2, CN, or CF3, wherein R is H or straight or branched chain alkyl (1-6C). Phenyl moieties may also be substituted with an additional phenyl residue, preferably at the 4-position. Any two substituents may form a 5-7 membered carbocyclic or heterocyclic ring subject to the proviso. The additional phenyl residue may itself be substituted with the substituents set forth above. The additional phenyl may be substituted in all five positions, but preferably less, preferably in 1-2 positions or not at all.
Preferred substituents include halo, alkyl (1-6C), OR, SR and NR2, more preferably halo, OR and alkyl (1-4C), most preferably halo and OCH3. The substituents on the phenyl moiety as an embodiment of Ar1 or on Ph may occupy all five available positions, preferably 1-2 positions or the phenyl is unsubstituted If Ar1 comprises a pyridyl residue, only 4 positions are available; preferably only 1-2 positions are substituted or preferably the pyridyl is unsubstituted. If Ar1 comprises furanyl or thiophenyl, only 3 positions are available; preferred numbers of substitutions in this case are 1 or 0.
n may be 0 or 1, and is preferably 0. However, when n is 1, Y is present and may be alkyl, arylalkyl or aryl, all of which may optionally be substituted by the substituents set forth above. Preferred embodiments of Y include unsubstituted alkyl (1-6C) and unsubstituted arylalkyl (7-11C), most preferably unsubstituted lower alkyl (1-4C).
The compounds of formula (1) or (2) may be supplied in the form of their pharmaceutically acceptable acid-addition salts including salts of inorganic acids such as hydrochloric, sulfuric, hydrobromic, or phosphoric acid or salts of organic acids such as acetic, tartaric, succinic, benzoic, salicylic, and the like. If a carboxyl moiety is present on the compounds of formula (1) or (2), the compound may also be supplied as a salt with a pharmaceutically acceptable cation.
In the event the compounds of formula (1) or (2) contains one or more chiral centers, all of the stereoisomers are included within the scope of the invention, as well as mixtures thereof Thus, the compounds of formula (1) or (2) in these instances may be supplied as a single stereoisomer, as a racemic mixture, as a partially racemic mixture, or generally, a mixture of stereoisomers in any proportion.
The invention is directed, in addition to methods of treatment, to compounds falling within the scope of formula (1) or (2) as compositions of matter.
In particular, the invention is directed to compounds of the general formula (2), and the pharmaceutically acceptable salts thereof, wherein Ar1 is optionally substituted furanyl, thiophenyl, phenyl system containing 0, 1 or 2 N as heterocyclic atoms or naphthyl system containing 0 1, 2 or 3 N as heterocyclic atoms, X1 is CO or an isostere thereof; Y is optionally substituted alkyl (1-6C), optionally substituted aryl (6-10C), or optionally substituted arylalkyl (7-11C); n is 1; Z is N or CH; X2 is CH2 or an isostere thereof; and Ph is optionally substituted phenyl.
The invention is also directed to compounds of formula (2) and the pharmaceutically acceptable salts thereof, wherein Ar1 is optionally substituted furanyl, thiophenyl, phenyl system containing 1 or 2 N atoms as heterocyclic atoms or naphthyl system containing 0, 1, 2, or 3 N atoms as heterocyclic atoms, X1 is CO or an isostere thereof; Y is optionally substituted alkyl (1-6C), optionally substituted aryl (6-10C), or optionally substituted arylalkyl (7-11C); n is 0-1; Z is N or CH; X2 is CH2 or an isostere thereof; and Ph is optionally substituted phenyl; wherein said substituents on Ar1 and Ph are independently selected from the group consisting of straight or branched chain alkyl (1-6C), straight or branched chain alkenyl (2-6C), halo, RCO, COOR, CONR2, SO2NR2, xe2x80x94OOCR, xe2x80x94NROCR, xe2x80x94NROCOR, OR, SR, NR2, NO2, CN, or CF3, wherein R is H or straight or branched chain alkyl (1-6C).
The invention is also directed to a compound of the formula (2) and the pharmaceutically acceptable salts thereof, wherein Ar1 is an ortho substituted furanyl, thiophenyl, phenyl system containing 0, 1 or 2 N as heterocyclic atoms, or naphthyl system containing 0, 1, 2 or 3 N as heterocyclic atoms; said ortho substituent is straight or branched chain alkyl (1-6C), straight or branched chain alkenyl (2-6C), halo, RCO, COOR, CONR2, SO2NR2, xe2x80x94OOCR, xe2x80x94NROCR, xe2x80x94NROCOR, OR, SR, NR2, NO2, CN, or CF3, wherein R is H or straight or branched chain alkyl (1-6C), with the proviso that when said Ar1 is phenyl and said ortho substituent is OR, either R must be alkyl (3-6C) or Ar1 must be 
where Rxe2x80x2 is H, alkyl (1-6C), alkenyl (2-6C) or arylalkyl (7-12C);
X1 is CO or an isostere thereof, Y is optionally substituted alkyl (1-6C), optionally substituted aryl (6-10C), or optionally substituted arylalkyl (7-11C); n is 0-1; Z is N or CH; and Ph is optionally substituted phenyl.
The ortho position is defined herein as the position in the ring adjacent the X1 position, for example the 2-position in a 5-membered ring.
Preferred embodiments of the compounds of the invention are as described above with respect to compounds useful in the invention methods. In particular piperidine forms are preferred over piperazines.
Particularly preferred compounds of the invention include:
1-(2-methoxy-4-hydroxybenzoyl)-4-benzylpiperidine;
1-(2-methoxy-4-methoxybenzoyl)-4-benzylpiperidine;
1-(2-methoxy-4-benzyloxybenzoyl)-4-benzylpiperidine; and
1-(2-methoxy-4-methoxybenzoyl)-4-(4-fluorobenzyl)piperidine.
In addition, the following table illustrates preferred compounds of the invention.
The invention is also directed to methods to prepare the compounds useful in the invention by forming the carboxamides from the appropriate aroyl compounds as halides or free acids.
Synthesis Methods
Preferably, the compounds useful in the invention are synthesized, generally, by coupling an aroyl moiety to a benzyl-substituted piperazine or piperidine. The general approach is shown in Reaction Schemes 1-6 hereinbelow. Reaction Scheme 3 is directed to the particular circumstance wherein Ar2 includes an amino group to be functionalized in the presence of potentially competing groups. 
Administration and Use
The methods of the invention are directed to treating conditions associated with p38 kinase activity, for example, inflammatory conditions. Thus, the compounds of formula (1) or their pharmaceutically acceptable salts are used in the manufacture of a medicament for prophylactic or therapeutic treatment of mammals, including humans, in respect of conditions characterized by excessive production of cytokines and/or inappropriate or unregulated cytokine activity on such cells as cardiomyocytes, cardiofibroblasts and macrophages.
The compounds of formulas (1) and (2) inhibit the production of cytokines such as TNF, IL-1, IL-6 and IL-8, cytokines that are important proinflammatory constituents in many different disease states and syndromes. Thus, inhibition of these cytokines has benefit in controlling and mitigating many diseases. The compounds of formulas (1) and (2) are shown herein to inhibit a member of the MAP kinase family variously called p38 MAPK (or p38), CSBP, or SAPK-2. The activation of this protein has been shown to accompany exacerbation of the diseases in response to stress caused, for example, by treatment with lipopolysaccharides or cytokines such as TNF and IL-1. Inhibition of p38 activity, therefore, is predictive of the ability of a medicament to provide a beneficial effect in treating diseases such as coronary artery disease, congestive heart failure, cardiomyopathy, myocarditis, vasculitis, restenosis, such as occurs following coronary angioplasty, atherosclerosis, rheumatoid arthritis, rheumatoid spondylitis, osteoarthritis, gouty arthritis and other arthritic conditions, multiple sclerosis, acute respiratory distress syndrome (ARDS), asthma, chronic obstructive pulmonary disease (COPD), silicosis, pulmonary sarcosis, sepsis, septic shock, endotoxic shock, toxic shock syndrome, heart and brain failure (stroke) that are characterized by ischemia and reperfusion injury, surgical procedures, such as transplantation procedures and graft rejections, cardiopulmonary bypass, coronary artery bypass graft, CNS injuries, including open and closed head trauma, inflammatory eye conditions such as conjunctivitis and uveitis, acute renal failure, glomerulonephritis, inflammatory bowel diseases, such as Crohn""s disease or ulcerative colitis, graft vs host disease, bone resorption diseases like osteoporosis, type II diabetes, pyresis, psoriasis, cachexia, viral diseases such as those caused by HIV, CMV, and Herpes, and cerebral malaria.
Within the last several years, p38 has been shown to comprise a group of MAP kinases designated p38xcex1, p38xcex2, p38xcex3 and p38xcex4. Jiang, Y. et al. J Biol Chem (1996) 271:17920-17926 first reported characterization of p38xcex2, as a 372-amino acid protein closely related to p38xcex1. Kumar, S. et al. Biochem Biophys Res Comm (1997) 235:533-538 and Stein, B. et al. J Biol Chem (1997) 272:19509-19517 reported a second isoform of p38xcex2, p38xcex22 containing 364 amino acids with 73% identity to p38xcex1. All of these reports show evidence that p38xcex2 is activated by proinflammatory cytokines and environmental stress, although the second reported p38xcex2 isoform, p38xcex22, appears to be preferentially expressed in the CNS, heart and skeletal muscle compared to the more ubiquitous tissue expression of p38xcex1. Furthermore, activated transcription factor-2 (ATF-2) was observed to be a better substrate for p38xcex22 than for p38xcex1, thus suggesting that separate mechanisms of action may be associated with these forms. The physiological role of p38xcex21 has been called into question by the latter two reports since it cannot be found in human tissue and does not exhibit appreciable kinase activity with the substrates of p38xcex1.
The identification of p38xcex3 was reported by Li, Z. et al. Biochem Biophys Res Comm (1996) 228:334-340 and of p38xcex4 by Wang, X., et al., J Biol Chem (1997) 272:23668-23674 and by Kumar, S., et al., Biochem Biophys Res Comm (1997) 235:533-538. The data suggest that these two p38 isoforms (xcex3 and xcex4) represent a unique subset of the MAPK family based on their tissue expression patterns, substrate utilization, response to direct and indirect stimuli, and susceptibility to kinase inhibitors.
Various results with regard to response to drugs targeting the p38 family as between p38xcex1 and either the putative p38xcex21 or p38xcex22 or both were reported by Jiang, Kumar, and Stein cited above as well as by Eyers, P. A. et al. Chem and Biol (1995) 5:321-328. An additional paper by Wang, Y. et al. J Biol Chem (1998) 273:2161-2168 suggests the significance of such differential effects. As pointed out by Wang, a number of stimuli, such as myocardial infarction, hypertension, valvular diseases, viral myocarditis, and dilated cardiomyopathy lead to an increase in cardiac workload and elevated mechanical stress on cardiomyocytes. These are said to lead to an adaptive hypertrophic response which, if not controlled, has decidedly negative consequences. Wang cites previous studies which have shown that in ischemia reperfusion treated hearts, p38 MAPK activities are elevated in association with hypertrophy and programmed cell death. Wang shows in the cited paper that activation of p38xcex2 activity results in hypertrophy, whereas activation of p38xcex1 activity leads to myocyte apoptosis. Thus, selective inhibition of p38xcex1 activity as compared to p38xcex2 activity will be of benefit in treating conditions associated with cardiac failure. These conditions include congestive heart failure, cardiomyopathy, myocarditis, vasculitis, vascular restenosis, valvular disease, conditions associated with cardiopulmonary bypass, coronary artery bypass, grafts and vascular grafts. Further, to the extent that the xcex1-isoform is toxic in other muscle cell types, xcex1-selective inhibitors would be useful for conditions associated with cachexia attributed to TNF or other conditions such as cancer, infection, or autoimmune disease.
Thus, the invention is directed to the use of the compounds of formulas (1) and (2) which selectively inhibit the activity of the p38xcex1 isoform for treating conditions associated with activation of p38xcex1, in particular those associated with cardiac hypertrophy, ischemia or other environmental stress such as oxidation injury, hyperosmolarity or other agents or factors that activate p38xcex1 kinase, or cardiac failure, for example, congestive heart failure, cardiomyopathy and myocarditis.
The manner of administration and formulation of the compounds useful in the invention will depend on the nature of the condition, the severity of the condition, the particular subject to be treated, and the judgement of the practitioner; formulation will depend on mode of administration. As the compounds of formulas (1) and (2) are small molecules, they are conveniently administered by oral administration by compounding them with suitable pharmaceutical excipients so as to provide tablets, capsules, syrups, and the like. Suitable formulations for oral administration may also include minor components such as buffers, flavoring agents and the like. Typically, the amount of active ingredient in the formulations will be in the range of 5%-95% of the total formulation, but wide variation is permitted depending on the carrier. Suitable carriers include sucrose, pectin, magnesium stearate, lactose, peanut oil, olive oil, water, and the like.
The compounds of formulas (1) and (2) may also be administered through suppositories or other transmucosal vehicles. Typically, such formulations will include excipients that facilitate the passage of the compound through the mucosa such as pharmaceutically acceptable detergents.
The compounds may also be administered topically, for topical conditions such as psoriasis, or in formulation intended to penetrate the skin. These include lotions, creams, ointments and the like which can be formulated by known methods.
The compounds may also be administered by injection, including intravenous, intramuscular, subcutaneous or intraperitoneal injection. Typical formulations for such use are liquid formulations in isotonic vehicles such as Hank""s solution or Ringer""s solution.
Alternative formulations include nasal sprays, liposomal formulations, slow-release formulations, and the like, as are known in the art.
Any suitable formulation may be used. A compendium of art-known formulations is found in Remington""s Pharmaceutical Sciences, latest edition, Mack Publishing Company, Easton, Pa. Reference to this manual is routine in the art.
The dosages of the compounds of formula (1) will depend on a number of factors which will vary from patient to patient. However, it is believed that generally, the daily oral dosage will utilize 0.001-100 mg/kg total body weight, preferably from 0.01-50 mg/kg and more preferably about 0.01 mg/kg-10 mg/kg. The dose regimen will vary, however, depending on the conditions being treated and the judgment of the practitioner.
The inhibitors of p38 kinase can be used as single therapeutic agents or in combination with other therapeutic agents. Drugs that could be usefully combined with these compounds include natural or synthetic corticosteroids, particularly prednisone and its derivatives, monoclonal antibodies targeting cells of the immune system, antibodies or soluble receptors or receptor fusion proteins targeting immune or non-immune cytokines, and small molecule inhibitors of cell division, protein synthesis, or mRNA transcription or translation, or inhibitors of immune cell differentiation or activation.
As implicated above, although the compounds of formula (1) may be used in humans, they are also available for veterinary use in treating animal subjects.